Dear OCD Sister,

Yes, we have absolutely heard of OCD with intrusive thoughts. In fact, it is far more common than you might imagine. Many people think of Obsessive Compulsive Disorder (OCD) as excessive hand washing or checking that the stove is really turned off. But, in reality, intrusive thoughts often define this  disorder. And you don’t have to have OCD to experience intrusive thoughts. A major study led by Concordia University found that 94% of people have some intrusive thoughts, the most common of which have to do with self-harm, violence toward others, contamination, and doubt so you are definitely not alone.

The main difference between folks with OCD and other folks is how much these thoughts disrupt their lives. Being anxious about them often makes the thoughts occur even more frequently and for a longer period of time thereby causing major obstacles to daily functioning.

We have a few thoughts to share with you.

• First and foremost, practice self-compassion. We know it is easy to get angry and frustrated with yourself, but it is important to remember that you did not choose OCD—it is a brain disorder. So speak gently to yourself about it. Instead of “why can’t I stop this?” try “because of my disorder, I am having intrusive thoughts and it is really scary.” In other words, talk to yourself as you would a close friend going through something similar. When you stay calm and gentle, you will be better able to use the techniques you’ve learned in therapy to deal with the thoughts.

• Speaking of therapy (which is a really important component of treatment for those suffering from OCD), you may want to check that your therapist has some experience and training specifically with OCD. The current gold standard is a treatment protocol known as Exposure and Response Prevention (ERP), which gradually exposes you to your obsession or intrusive thoughts in a safe environment, which starts to decrease the anxiety you feel when you get them. There are, of course, other treatment modalities, but this is the one that is the most researched and relied upon in the OCD community.

• Medication can be a real game changer in managing the symptoms of OCD. Abs often says that she got her life back when she went on Prozac because her intrusive thoughts really receded. Also, some folks find ERP to be too difficult without the aid of pharmaceuticals—at least in the beginning.

• Lastly, people have all sorts of intrusive thoughts—some of them frightening and taboo—but the content of the thought is really less important than recognizing that the root of the thought is based in OCD rather than in any connection to reality. In other words, having intrusive thoughts about self-harm does not mean that you want to harm yourself—those thoughts are just the form that your OCD takes. Thoughts are not facts. As such, we find self-talk to be really helpful. Tell yourself, out loud if possible, “These are just thoughts” or “This is just my OCD talking”